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巴西和泰国感染艾滋病毒的跨性别女性、顺性别女性及男男性行为者中的抑郁、性行为与艾滋病毒治疗结果:简短报告

Depression, sexual behavior, and HIV treatment outcomes among transgender women, cisgender women and men who have sex with men living with HIV in Brazil and Thailand: a short report.

作者信息

Poteat Tonia C, Celentano David D, Mayer Kenneth H, Beyrer Chris, Mimiaga Matthew J, Friedman Ruth K, Srithanaviboonchai Kriengkrai, Safren Steven A

机构信息

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA.

出版信息

AIDS Care. 2020 Mar;32(3):310-315. doi: 10.1080/09540121.2019.1668526. Epub 2019 Sep 17.

Abstract

One in five transgender women (TW) are living with HIV, yet little has been published about their health outcomes. We analyzed data from TW ( = 37), cisgender women (CW,  = 165), and cisgender men who have sex with men (MSM,  = 151) in Thailand and Brazil. We hypothesized: (1) TW will have higher odds of depressive symptoms, lower odds of condom use and greater odds of a detectable viral load compared to MSM and CW; and (2) TW will have lower odds of condom use and higher odds of detectable viral load. We found that TW had higher odds of depression (OR 2.2, 95%CI: 1.0, 4.8,  = 0.04) and were less likely than MSM (22% v. 42%,  = 0.01) to use condoms with partners of unknown serostatus. In multivariable models, TW had lower odds than MSM of using condoms with partners with unknown serostatus (OR 0.38, 95%CI: 0.15, 0.90) and CW had lower odds than MSM of using condoms with HIV-negative partners (0.60 [0.38, 0.95],  = 0.029). We found no significant differences in detectable viral load. Disaggregating data by gender is important to understand factors that contribute to viral suppression and HIV transmission risk among people living with HIV.

摘要

五分之一的跨性别女性感染了艾滋病毒,但关于她们健康状况的公开报道却很少。我们分析了泰国和巴西的跨性别女性(37人)、顺性别女性(165人)以及与男性发生性关系的顺性别男性(151人)的数据。我们假设:(1)与男男性行为者和顺性别女性相比,跨性别女性出现抑郁症状的几率更高,使用避孕套的几率更低,病毒载量可检测到的几率更高;(2)跨性别女性使用避孕套的几率更低,病毒载量可检测到的几率更高。我们发现,跨性别女性患抑郁症的几率更高(比值比2.2,95%置信区间:1.0,4.8,P = 0.04),并且与男男性行为者相比(22%对42%,P = 0.01),在与血清学状态不明的性伴发生性行为时使用避孕套的可能性更小。在多变量模型中,跨性别女性与血清学状态不明的性伴发生性行为时使用避孕套的几率低于男男性行为者(比值比0.38,95%置信区间:0.15,0.90),顺性别女性与艾滋病毒阴性性伴发生性行为时使用避孕套的几率低于男男性行为者(0.60[0.38,0.95],P = 0.029)。我们发现可检测到的病毒载量没有显著差异。按性别对数据进行分类对于了解影响艾滋病毒感染者病毒抑制和艾滋病毒传播风险的因素很重要。

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